Ductus arteriosus and the preterm brain.
Valerie Y ChockShazia BhombalGabriel Fernando Todeschi VarianeKrisa P Van MeursWilliam E BenitzPublished in: Archives of disease in childhood. Fetal and neonatal edition (2022)
As the approach to the patent ductus arteriosus (PDA) in the preterm infant remains controversial, the potential consequences of a significant ductal shunt on the brain should be evaluated. In this population at high risk of adverse outcomes, including intraventricular haemorrhage and white matter injury, as well as longer-term neurodevelopmental impairment, it is challenging to attribute sequelae to the PDA. Moreover, individual patient characteristics including gestational age and timing of PDA intervention factor into risks of brain injury. Haemodynamic assessment of the ductus combined with bedside neuromonitoring techniques improve our understanding of the role of the PDA in neurological injury. Effects of various PDA management strategies on the brain can similarly be investigated. This review incorporates current understanding of how the PDA impacts the developing brain of preterm infants and examines modalities to measure these effects.
Keyphrases
- white matter
- gestational age
- brain injury
- preterm infants
- cerebral ischemia
- resting state
- preterm birth
- low birth weight
- birth weight
- multiple sclerosis
- subarachnoid hemorrhage
- functional connectivity
- randomized controlled trial
- climate change
- pulmonary artery
- human health
- pulmonary arterial hypertension
- coronary artery
- high resolution